Provider Demographics
NPI:1083327837
Name:BELFROM PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:BELFROM PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGSIT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELFROM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:214-701-9641
Mailing Address - Street 1:413 W BETHEL RD STE 202
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-4475
Mailing Address - Country:US
Mailing Address - Phone:214-701-9641
Mailing Address - Fax:
Practice Address - Street 1:413 W BETHEL RD STE 202
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-4475
Practice Address - Country:US
Practice Address - Phone:214-701-9641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-26
Last Update Date:2022-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)